Department for Small Animal, Faculty of Veterinary Medicine, Leipzig University, 04103, Leipzig, Germany.
Section of Clinical and Comparative Neuropathology, Ludwig-Maximilians-Universität, Munich, Germany.
J Small Anim Pract. 2022 Jun;63(6):468-481. doi: 10.1111/jsap.13482. Epub 2022 Feb 9.
The aim of the retrospective study was to describe the brain biopsy procedure using a new frameless optical neuronavigation system and to report diagnostic yield and complications associated with the procedure.
The medical records for all dogs with forebrain lesions that underwent brain biopsy with a frameless optical neuronavigation system in a single referral hospital between 2013 and 2020 were retrospectively analysed. Following data were collected: signalment, neurological signs, diagnostic findings, number of brain biopsy samples, sampled region, complications, duration of hospitalisation, whether the samples were diagnostic and histopathological diagnoses. The device consists of a computer workstation with navigation software, an infrared camera, patient tracker and reflective instruments. The biopsy needle was equipped with reflective spheres, so the surgeon could see the position of the needle during sampling the intracranial lesion free handed through a mini-burr hole.
Ten dogs were included. Absolute diagnostic yield based on specific histopathological diagnosis was 73.9%. Three dogs had immune-mediated necrotizing encephalitis, two dogs showed a necrotizing leukoencephalitis and two dogs a meningoencephalitis of unknown origin. In two dogs, the brain specimen showed unspecific changes. In one dog, the samples were non-diagnostic. Seven dogs showed no neurological deterioration, one dog mild temporary ataxia and two dogs died within 36 hours post brain biopsy.
In these 10 dogs, the frameless optical neuronavigation system employed was useful to gain diagnostic brain biopsy samples. Considering the mortality rate observed, further studies are needed to confirm the safety of this procedure and prove its actual clinical effectiveness.
本回顾性研究的目的是描述使用新型无框架光学神经导航系统进行脑活检的过程，并报告与该过程相关的诊断率和并发症。
回顾性分析了 2013 年至 2020 年间，在一家转诊医院，所有因前脑病变而行无框架光学神经导航系统脑活检的犬的病历。收集的资料包括：品种、神经症状、诊断结果、脑活检样本数量、取样部位、并发症、住院时间、样本是否有诊断价值和组织病理学诊断。该设备由带导航软件的计算机工作站、红外摄像机、患者跟踪器和反射仪器组成。活检针配备了反射球，因此在通过微型骨孔徒手取样颅内病变时，外科医生可以看到针的位置。
10 只犬被纳入研究。基于特定组织病理学诊断的绝对诊断率为 73.9%。3 只犬患有免疫介导性坏死性脑炎，2 只犬患有坏死性脑脊髓炎，2 只犬患有不明原因的脑膜脑炎。在 2 只犬中，脑组织标本显示为非特异性改变。在 1 只犬中，样本无诊断价值。7 只犬无神经功能恶化，1 只犬轻度暂时性共济失调，2 只犬在脑活检后 36 小时内死亡。
在这 10 只犬中，使用的无框架光学神经导航系统有助于获得有诊断价值的脑活检样本。考虑到观察到的死亡率，需要进一步的研究来证实该操作的安全性并证明其实际临床效果。
